Glossary
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Ablate: To remove, or vaporize, tissue using laser energy.
Ablation zone: The area of tissue removed by the laser. Also
called the treatment zone.
Accommodation: The ability of the eye’s lens to fine-tune
focus by flexing, becoming more convex or more concave, as needed.
Accommodation can compensate for minor focusing problems in younger
people whose lens and surrounding muscles are still limber and
pliable.
Antibiotic drops: Eyedrops containing medicine that prevents
infection by killing or inhibiting harmful bacteria.
Anti-inflammatory drops: Eyedrops containing medicine that counteracts
inflammation, which is characterized by redness, heat, pain,
and swelling.
Artificial tears: Sterile, nonpreserved eyedrops used to lubricate
the eyes the same way tears do.
Astigmatism: A refractive error caused by an asymmetrically
shaped cornea. Rather than being spherical in shape, the cornea
is shaped like a football, causing light to come to several points
of focus instead of meeting at a single point of focus. People
with astigmatism experience blurred images or double vision.
Automated lamellar keratoplasty (ALK): An older refractive surgery,
developed in 1987, in which the surgeon first creates an extremely
thin flap in the uppermost layer of the cornea using a device
called a microkeratome, then makes a second pass with the microkeratome
to remove additional tissue.
Axis: A measurement of astigmatism, the axis (a line) is the
symmetrical center of a curved optical surface.
Benchmarking: The process of tracking statistical outcomes for
the purpose of predicting future outcomes. With LASIK eye surgery, statistics
from 1,000 or more procedures can provide a good basis for benchmarking.
Best corrected vision: The best possible vision achieved with
corrective lenses.
Blended vision: See monovision.
Board-certified: Physicians who have undergone the additional
education, internships, residencies, and examinations required
for certification.
Cataract: Clouding of the lens within the eye causing decreased
vision.
Central island: A treatable complication from LASIK in which
a small raised area in the center of the cornea’s treatment
zone results from having received less laser energy than the
surrounding tissue. Central islands can cause distorted vision.
Central lamellar keratitis (CLK): An inflammation on the cornea
between the corneal flap and the stroma. This rare complication
of LASIK eye surgery is characterized by small deposits under the corneal
flap that can sometimes damage the underlying stroma enough to
affect vision and require an enhancement procedure.
Constrict: To become smaller.
Cornea: The outer, dome-shaped, transparent part of the eye
that bulges out at the front of the eyeball and covers the iris
and pupil. Its curvature causes light to bend. The cornea provides
most of the eye’s focusing power. It is the only part of
the eye on which LASIK is performed.
Corneal topographer: An instrument that creates a three-dimensional
map of the cornea using computerized analysis.
Cryolathe: A mechanical lathe used to grind a frozen corneal
disc into a new shape before it is replaced on the eye.
Crystalline lens: See lens.
Cylinder: One of three measures in an eyeglass prescription.
It indicates whether astigmatism is present, and to what degree.
Diffuse lamellar keratitis (DLK): A potential complication of
LASIK, also known as “sands of the Sahara” syndrome.
DLK is a noninfectious inflammation that arises between the corneal
flap and the underlying stroma.
Dilate: To become larger, as when the pupil enlarges in very
dim light conditions.
Diopter: A measurement of refractive error. Hyperopia is measured
in terms of positive diopters. Myopia is measured in terms of
negative diopters.
Disease neutral: Something that neither prevents diseases nor
affects the treatment of diseases. LASIK eye surgery is considered disease
neutral.
Dry eye: A condition characterized by corneal dryness due to
inadequate tear production.
Endothelium: The innermost layer of the cornea, a single cell
thick, that helps regulate the cornea’s hydration.
Enhancement procedure: A secondary treatment with the excimer
laser to fine-tune one’s visual acuity after the initial
LASIK procedure. Enhancements take place after vision has stabilized,
usually two to three months after LASIK. Enhancements usually
do not require making a new corneal flap.
Epithelial ingrowth: A potential complication of LASIK eye surgery produced
when corneal surface cells, or epithelium, grow underneath the
corneal flap during the first month following surgery. The condition
is often easily diagnosed and treated.
Epithelium: The thin, protective, outermost surface of the cornea.
It is made up of the same kind of cells that cover most of the
body. The epithelium grows rapidly and continually regenerates.
Excimer laser: The type of laser used in refractive surgery
to remove corneal tissue. It emits highly precise pulses of ultraviolet
light to break up tissue, one molecular layer at a time, vaporizing
it without generating heat that could damage surrounding tissue.
Eyelid speculum: A device placed between the upper and lower
eyelids to keep the patient from blinking.
Ghosting: The appearance of double images or shadows around
images. Ghosting is sometimes experienced by people with astigmatism,
and can also result from irregular healing of the corneal surface
after LASIK.
Glaucoma: A disorder of the eye characterized by an increase
of pressure within the eyeball.
Halo: A complication of LASIK in which the patient sees additional
rings around lights at night. Halos often decrease with time.
Haze: Scarring of the corneal stroma, or corneal bed. Significant
haze is an extremely rare complication of LASIK surgery.
Herpes simplex: A recurrent viral infection of the eye characterized
by a painful sore on the eyelid or surface of the eye. It causes
inflammation of the cornea and can lead to blindness.
Hyperopia: Also known as farsightedness, hyperopia occurs when
the eyeball is too short from front to back, or the eye’s
focusing mechanism is too weak, causing light rays to be focused
behind, rather than on, the retina. People with hyperopia see
objects at a distance more clearly than close up, but may have
difficulty with both.
Induced astigmatism: A rare complication of LASIK eye surgery in which astigmatism
develops after the initial surgery. Most people can tolerate
a small degree of astigmatism. In more serious cases, induced
astigmatism can be treated with an enhancement, if necessary.
Inflammation: A localized response to an injury that results
in redness, heat, pain, and swelling, and can result in tissue
damage if left untreated.
Informed consent: A legal form the patient will be asked to
sign after thoroughly discussing the risks, benefits, alternative
options, and possible complications of LASIK.
Intraocular pressure: The pressure exerted by the fluid within
the eye that gives it its round, firm shape.
Iris: The colored ring of tissue in the eye that is behind the
cornea and in front of the lens. The muscles of the iris can
adjust the size of the opening, or pupil, to allow for larger
or smaller amounts of light to enter the eye.
Keratectomy: Surgical removal of any part of the cornea. In
the context of LASIK, keratectomy is the flap-making part of
the procedure.
Keratomileusis: Any process of carving, or reshaping, the cornea.
Lamellar: An adjective meaning “layered.” Lamellar
corneal surgery corrects focusing errors by removing or reshaping
some of the corneal layers.
LASIK: An acronym for laser-assisted in situ keratomileusis.
In LASIK eye surgery, a small instrument called a microkeratome creates an
extremely thin, hinged flap on the surface of the cornea. After
the flap is gently lifted back, the surgeon reshapes the corneal
stroma using an excimer laser. The corneal flap is then replaced,
and it quickly adheres. LASIK is a safe and pain-free form of
refractive eye surgery that has proven to be highly successful
and popular.
Latent hyperopia: An age-related phenomenon in which mild farsightedness
increases after age thirty or forty.
Lens: The globe-shaped natural lens of the eye, located behind
the iris, that helps fine-tune the angle of light to bring it
to a point of focus on the retina. As the lens becomes less flexible
with age, its ability to refine focus gradually decreases.
Microkeratome: The instrument a surgeon uses to create the corneal
flap in the uppermost layer of the cornea during the LASIK eye surgery procedure.
Monovision: A process by which the surgeon corrects one’s
dominant eye for seeing at a distance and one’s nondominant
eye for seeing objects close up.
Myopia: Also known as nearsightedness, myopia is due to a cornea
that has too much curvature, or an eyeball that is too long,
causing light to be focused in front of, rather than on, the
retina. People with myopia have difficulty seeing objects at
a distance.
Nomogram: The surgeon’s formula entered into the laser’s
computer calculation to further refine the manufacturer’s
recommended settings.
Nonfreeze keratomileusis: A process of reshaping the corneal
disc directly on the eye without having to remove the disc and
freeze it for the purpose of reshaping, as was done in early
lamellar surgeries, precursors to LASIK surgery.
Ophthalmology: The field of science dealing with diseases and
conditions of the eye.
Ophthalmologist: A medical doctor specializing in the diagnosis
and medical or surgical treatment of eye diseases.
Optic nerve: A bundle of nerve fibers, about the diameter of
a pencil, that connects to the nerve fiber layer of the retina
and terminates in the brain. The optic nerve carries the visual
messages from the photoreceptors of the retina to the brain,
where images are created and processed.
Optometrist: An eye-care professional specializing in the examination,
diagnosis, treatment, management, and prevention of diseases
and disorders of the eye.
Orthokeratology: A technique for treating myopia using a series
of rigid contact lenses to reshape the cornea. The lenses apply
pressure to the sides of the cornea, flattening them.
Overcorrection: A complication of LASIK eye surgery, overcorrection results
when the amount of correction resulting from the LASIK procedure
is more than intended.
Peripheral vision: The ability to see objects and movement outside
of, or on the periphery of, one’s direct line of vision.
Photoablation: The process of removing, or vaporizing, tissue
by means of laser energy.
Photorefractive keratectomy (PRK): A type of laser vision correction that reshapes the cornea by ablating, or vaporizing, the corneal
tissue one microscopic layer at a time using an excimer laser.
Unlike LASIK, in which a hinged corneal flap is first made and
lifted back, exposing the corneal bed, the sculpting process
used in PRK removes the outer (epithelial) layer of the cornea
as the laser energy works its way down to the corneal bed.
Presbyopia: Often confused with farsightedness, presbyopia (literally, “old
eyes”) is the age-dependent need for reading glasses or
bifocals, caused by the decreasing ability of the eye’s
lens and surrounding muscles to fine-tune focus.
Punctum plugs: Used in the treatment of dry eye, these tiny
silicone plugs are inserted into the tear-drainage openings of
one’s eyelid to delay the drainage of natural tears so
the eyes will stay moist.
Pupil: The small black dot, or opening, in the center of the
iris. The pupil changes its diameter in response to changes in
lighting.
Radial keratotomy (RK): A form of refractive surgery in which
the eye surgeon alters the shape of the cornea by making thin incisions
around the cornea in a spoke-like pattern. The incisions cause
the central portion of the cornea to flatten, treating myopia
and astigmatism.
Refract: To bend, as when light passes through a curved shape
such as a cornea or lens.
Refractive error: The degree to which one’s eye is able
to refract, or bend, light. People with refractive errors (focusing
problems) are nearsighted or farsighted, and may have astigmatism
as well.
Refractive surgery: Any type of surgery that changes the focusing
power of the eye in order to correct a refractive error. LASIK eye surgery
is a type of refractive surgery that corrects the eye’s
focusing ability by reshaping the curvature of the cornea.
Regression: A potential complication of LASIK eye surgery in which the eye
tends to drift back, or regress, toward its original refractive
error.
Retina: The light-sensitive layer of cells on the inner back
surface of the eye that processes light and functions much like
film in a camera. The retina converts light into electrical impulses
that are transmitted along the optic nerve to the brain, which
interprets the impulses as images.
Sclera: The tough “white” of the eye that makes
up five-sixths of the outer layer of the eyeball. Along with
the cornea, it protects the eyeball.
Snellen eye chart: The standard eye chart used by optometrists
and ophthalmologists to determine visual acuity.
Sphere: One of three measurements taken during an eye examination
to arrive at one’s eyeglass prescription. The sphere measures
where the eye focuses light—on the retina (normal vision)
in front of the retina (myopia), or behind the retina (hyperopia).
Starburst: A visual aberration in which the patient sees rays
radiating from lights viewed at night. Starbursts may be seen
by people who wear eyeglasses and contact lenses, and are sometimes
experienced by patients who have undergone LASIK.
Striae: Wrinkles or folds in the corneal flap that are a potential
complication of LASIK eye surgery. Striae can be smoothed out and corrected
if treated early.
Stroma: The strong, fibrous layer that makes up 90 percent of
the cornea’s thickness and provides the cornea with its
structure and shape. Also called the stromal bed, this is the
part of the cornea sculpted with the laser in LASIK surgery.
Tonometry: A procedure for measuring intraocular pressure, or
the pressure inside the eye.
Topical corticosteroid: A medicated eye drop that prevents inflammation
of the eye tissue following LASIK surgery.
Undercorrection: A complication of LASIK, undercorrection results
when the amount of correction resulting from the LASIK eye surgery procedure
is less than intended. Most undercorrections can be treated with
an enhancement procedure.
Visual acuity: The sharpness or clarity of vision that enables
one to distinguish fine details and shapes.
Vitreous humor: The gel-like substance, composed of about 99
percent water, that fills the main cavity of the eye between
the lens and the retinal wall.
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